Sexual Orientation and Gender Identity: Mental Health and Resources

Adolescence can be an exciting but also a challenging time, since it is a period when bodies change, schoolwork is more difficult, and friends and families might not understand your feelings and thoughts. Sometimes adolescents feel more anxious, depressed, or even suicidal. Other times, adolescents can turn to risky behaviors such as drugs, alcohol or sex. Lesbian, gay, bisexual, and queer youth, and youth who identify as transgender or gender nonconforming experience the same mental health issues as other adolescents. However, they may also feel alone and might not share their feelings about sexual orientation or gender identity because they fear people will reject them. Having this extra burden can cause these adolescents to have a higher risk for these serious mental health issues.

What do I do if I feel suicidal?

Stay safe and do not make an impulsive dangerous decision! The most important thing to do is to find someone supportive who you know. You don’t have to share all the details about what you are feeling right away, although it might help. If you can’t think of anyone supportive, try calling a hotline (see resources below) or even 911 so you can talk to a mental health professional, or go to the closest emergency room.

Who should I tell about my sexual orientation and/or gender identity?

Not everyone will be accepting of lesbian, gay, bisexual, queer, and/or transgender or gender nonconforming identities. Deciding who to tell can be a difficult decision. You may choose to share your sexual orientation or gender identity with everyone you know or just a few close personal friends or family members. It’s important to find at least one supportive person you trust to tell so you don’t have to carry the heavy burden of a secret alone. If you can’t think of a supportive person in your life, you should contact a mental health professional or one of the professional online resources listed below so you won’t feel alone with these feelings. Don’t pick random unknown websites for support; they may not be helpful or knowledgeable about sexual orientation and gender identity.

No. Therapists and other mental health professionals are trained to maintain strict confidentiality about your sexual feelings and behaviors as well as gender identity questions. However, at your first appointment make sure to discuss confidentiality with your mental health provider and how and if information is shared with parents or others.

In general, no. Therapists are always concerned about your health and safety so they will break your confidentiality in the event that your actions/thoughts might lead to an unsafe situation for you or others (for example, if you were feeling suicidal). However, they would only discuss the details needed to get you the services you need. An ongoing conversation with your therapist about confidentiality is important.

Where can I get support?

This is an individual decision for every person. The most important thing is to find someone who you think will be accepting of you regardless of your sexual orientation and/or gender identity.

This may include:

An accepting friend

An accepting parent or other family member

Someone who you know who is lesbian, gay, bisexual, queer, and/or transgender or gender nonconforming

An accepting guidance counselor

A Gay-Straight Alliance at your school (this group may have a different name at your school, such as the Queer-Straight Alliance or the Pride Club)

If you can’t think of anyone who will be supportive of your thoughts and feelings, you don’t have to be alone. Usually, a mental health professional can help you figure out who might be a good support person.

“I can’t think of a single person who will be supportive of my feelings.” What are some trusted online resources I can turn to?

There are plenty of online professional resources and hotlines for the many adolescents who have similar thoughts and feelings about their sexual orientation and/or gender identity. See below for a list of resources.

“I have a friend who just told me about their feelings related to their sexual orientation and/or gender identity. How can I help them?”

Even if you are uncomfortable with your own feelings about sexual orientation and gender identity, let your friend know that you will support them and be there for them no matter what. Anyone who is willing to share private feelings and thoughts with you probably trusts you as a close friend and support person. Advise them to talk with their health care provider or start seeing a therapist so they don’t have to feel alone. You can also share with them some of the online resources listed below.

“I have a lesbian, gay, bisexual queer, and/or transgender or gender nonconforming friend who just told me about having suicidal thoughts. How can I help them?”

Again, let that friend know that they are not alone. Find out if they are with someone who can support them. Let them know that you won’t break their secret about their sexual orientation and/or gender identity, but that you still have to let someone know about their unsafe feelings. Then, stay with your friend and right away let a supportive adult know, call a hotline, or even 911 to make sure your friend stays safe!

Young Men’s Health (YMH) is produced by the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital. The purpose of the website is to provide carefully researched health information to teenage boys and young men.